Precocious pubarche is associated with SGA, prematurity, weight gain, and obesity

• Published in: Archives of disease in childhood Vol. 90; no. 3; pp. 258 - 261
• Main Authors: Neville, K A, Walker, J L
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.03.2005; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: adrenal glands; AGA; appropriate for gestational age; Biological and medical sciences; Birth weight; BMI; body mass index; Body Weight; bone age; Cardiovascular disease; Causes of; Chi-Square Distribution; Child, Preschool; Children; Children & youth; Correlation; Female; Females; fetal growth retardation; Gestational age; Gynecology. Andrology. Obstetrics; Health aspects; Humans; Hypotheses; Infant; Infant, Newborn; Infant, Premature; Infant, Small for Gestational Age; Ischemia; low birth weight; Male; Males; Medical sciences; Metabolic diseases; Neonates; New South Wales; Obesity; Obesity - etiology; Original; Overweight; Pathology; Patients; Ponderal Index; Precocious puberty; Pregnancy; prematurity; Puberal and climacteric disorders (male and female); Puberty, Precocious - etiology; Retrospective Studies; Risk factors; SDS; SGA; small for gestational age; standard deviation score; Weight Gain; New South Wales; Endocrinopathy; Human; Obesity; Pediatrics; Intrauterine growth retardation; Pregnancy disorders; Nutrition disorder; Weight gain; Precocious puberty; Fetal diseases; Association; Prematurity; Prepuberty; Risk factor; Child; Nutritional status; Public health
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2004.053959

Background: Perinatal stress is thought to underlie the Barker sequelae of low birth weight, of which precocious pubarche may be a manifestation. Aims: To explore whether prematurity as well as smallness for gestational age (SGA) predisposes to precocious pubarche, and the potential role of excess weight gain during childhood. Methods: Retrospective chart review of 89 children (79 girls) with precocious pubarche. Results: Sixty five per cent were overweight/obese at diagnosis, compared with 19–24% of Australian children. Thirty five per cent had a history of SGA and 24% of prematurity. Weight SDS increased from birth to diagnosis in 91% of children. The mean change in weight SDS from birth to diagnosis was greater in those who were SGA (2.8, 95% CI 2.2 to 3.4) versus AGA (1.7, 95% CI 1.3 to 2.2), with no difference in the incidence of overweight/obesity. The latter was lower among children born premature (40% versus 72% term) but was associated with a mean increase in weight of 1.3 SDS during childhood. Nine out of ten girls and boys with precocious pubarche had at least one of the three risk factors studied. Conclusions: Both prematurity and SGA were associated with precocious pubarche, as was overweight/obesity, irrespective of size or gestation at birth. Excess weight gain in childhood may predispose to precocious pubarche in susceptible individuals.